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How Do I Set Up a Small Group Health Plan in California
 

With 20+ years of experience, we aim to take all the heavy lifting away from the process.


It's actually quite a bit easier than when we first started but most of the difficulty revolves around choosing the right plan and contribution level.


We went through top tips of how to save on group health but let's now dive into the enrollment side to make it a seamless process.


Here are the topics we'll cover:


What paperwork do you need to start a group health plan in California
How many employees do you need to start a group health plan
What effective date can you pick
How do you get the employee rates
What is required to give to each employee during enrollment
How can I get assistance in starting a group health plan in California
How long does the process take


Let's get started!


What paperwork do you need to start a group health plan in California?


Each employer may have slightly different requirements but the basic paperwork is as follows:



For most companies, that's it!


Employer application


We'll guide you through the process...especially the employer app where there are quite a bit of catch-ya's.


After all, there's lots of regulation around health insurance and some of it reads like a tax form.


No worries...we can help with that process and finish it in 5 minutes.


Employee application for each enrolling employee


The employee apps are better but still not fun.


Lots of pages but about 3-4 are really needed.  Again, we can walk through this process and even help employees pick the best plan for their needs.


It's important as the employer that you don't get into their health history and situation.


Each employee who is enrolling would complete the form.


Make sure to complete the waiver for declining dependents, etc if needed.


Speaking of which…


Waiver for eligible employees not enrolling


For employees who are enrolling in any benefits, they need to complete the one-page waiver.


They will not be able to come on board until open enrollment or for certain qualifying events (marriage, birth, loss of other coverage, etc).


Ownership form for people not on payroll


This form is for people who do not show on payroll.


It's generally owners, officers, and LLC members or partners.


They may ask for additional proof such as K1 or schedule C's but the form may take care of tying the individual formally to the company.


Most recent payroll report DE9 (contact us if you don't have a DE9)


This is the big one to establish both eligibility and effective date.


Payroll is the gold standard of establishing we meet the basic requirements for setting up a company plan.


Check out our review on start-up companies or family businesses regarding flexibility on this front.


Otherwise, your most recent W2 or payroll if not available is needed.


Check by fax form or first payment


First month's premium is required upfront with group health plans.


There are no signup charges, admin fees, and our service is 100% free to you.


Again, we're here to help with the entire process so run your group health quote or email us at help@calhealth.net 


Let's look at some eligibility questions.


How many employees do you need to start a group health plan?


Technically, we need 1 employee on payroll to qualify.


This person can even be part-time.


The person cannot be the owner and/or spouse.


It can be a child of the owner who is employed and on payroll (key to family business health plans).


Small group is generally considered as 1-100 employees.


We need at least 50% of the eligible employees to enroll.  


Check out our Small business qualification page for more info.

 

How fast can the plan start?


What effective date can you pick?

What about the effective date?


Generally, we can pick the 1st of the month following submittal.


The carriers are generally pretty lenient and we may be able to submit paperwork days after the 1st and still get the 1st.


One note...for newer groups, the carriers can make us wait 45 days or ½ of the calendar quarter after we've met eligibility requirements!


This generally hinges on employees showing on the w2 or payroll.


We'll help with this estimation specific to your company.


How do you get the employee rates?


This is easy and we do all the heavy lifting.


We just need dates of birth and zip code.  Simply complete this form and we'll run the quotes across all major carriers.


From there we can zero in on the best-priced offering and create worksheets for employees based around a pre-determined amount the employer sets (fixed dollar or percentage of plan or percentage of a given plan).


Check out our tips for minimizing group health care costs to learn more.


What about ACA notification requirements?


What is required to give to each employee during enrollment?


We'll guide you through this process as well.


Essentially, we need to provide a summary of benefits to each employee as well as notification of Covered Ca options.


We can provide all of this at the time of enrollment and more.


Which brings up the next section.


How can I get assistance in starting a group health plan in California?


This is literally what we do.


Here's the important consideration for you:


There is ZERO cost for our assistance!  


The rates are identical through us, direct with the carrier, or through another agent.


The problem is that a carrier will only show you their rates and does not have an incentive to really zero down and find the best pricing (HSA's, narrow networks, etc).


OR….the drawbacks to those approaches.


A balanced look at options available to you.


The bigger issue is that in a given area for a given demographic, there can be such differences in pricing.  Wait till you see the market comparison.  


As for agents, we have decades of experience across California.


Just check out our Google reviews...we take this seriously and you'll hear the difference in just one call.


How can we help?


How long does the process take


The process has improved so much since when we first started back in the 1900s (added for flair).


It used to be a month-long slog with back and forth requirements.


We typically hear back within 1 week now with approval.


Of course, we go through and scrub all the paperwork on our side to make sure there's nothing missing or incorrect.


We can also highlight tips and tricks to offer flexibility and savings going forward during this process.


Otherwise, once the needed paperwork is submitted, about 1 week.


Membership generally takes a few more days and ID cards can be available shortly after especially if employees register their accounts online.


For any other questions on enrolling a California group health plan, please call 800-320-6269 or email us at help@calhealth.net 

 

You can quote Employer health plans here